Neurologia-Angol
N21N0001
Which is the strongest relationship in the „clinical sign – localization – causes” system of neurological diseases?
Signs and causes Signs and localization Localization and causes
The above relationships are equally strong
N21N0002
If nystagmus, ataxia and hemiparesis appears acutely in an elderly patient, we primarily consider:
Multiple sclerosis
Vertebrobasilar cerebrovascular insufficiency Alcohol intoxication
Exhaustion
N21N0003
Which of the below has no significance when taking the history
Age of the patient
Precise clarification of complaints Previous medication
All of the above are important
N21N0004
Heteroanamnesis must be taken if
The patient is a child
If the disease is associated with disturbance of consciousness If the patient is demented
In all the above cases
N21N0005
Which of the signs is a sign of meningeal irritation?
Diplopia Vertigo Kernig-sign Chaddock-sign
N21N0006
Which of the signs is not a sign of meningeal irritation?
Brudzinski-sign Kernig-sign
Nuchal stiffness due to spondylosis Hunting dog’s posture
N21N0007
Nuchal stiffness, as a sign of meningeal irritation should be differentiated from
Nuchal rigidity in Parkinson-syndrome
Pain and muscular defense in degenerative diseases of the cervical spine Nuchal stiffness in severe exsiccosis
All of the above
N21N0008
Hip and knee flexion of a patient in supine position when the head is bent forward is called
Kernig-sign Brudzinski-sign Bell-phenomenon Gordon-reflex
N21N0009
Part of the fibers of the olfactory tract decussate in the
Corpus callosum
Substantia grisea centralis Commissura anterior alba Fornix
N21N0010
What happens with the fibers of the optic nerve originating from the nasal half of the retina?
Decussate in the optic chiasm Witch to the next nerve in the chiasm
Without crossing to the other side, they run further on the same side
Without entering the chiasm they get into the lateral geniculate body (corpus geniculatum laterale)
N21N0011
Papilledema can be caused by Chronic subdural haematoma Intracranially growing tumor
Pseudotumor cerebri All of the above
N21N0012
When examining eye movements we evaluate the function of the following cranial nerves:
II.- III.- VI III.—IV. – V.
III. – IV. – VI.
II. – IV. – VI.
N21N0013
Which cranial nerves have a role in the cornea reflex?
Exclusively CN. V.
Exclusively CN. VII.
Both CN. V. And CN. VII.
CN II., CN V. and CN VII.
N21N0014
In right sided lower motor neuron („peripheral”) facial palsy
Exe closure and smiling is intact and symmetrical on both sides
Forehead wrinkling, eye closure and smiling is performed with decreased strength on the left side
Forehead wrinkling, eye closure and smiling is performed with decreased strength on the right side
Forehead wrinkling, eye closure is performed with normal strength bilaterally, smiling is performed with decreased strength on the right side
N21N0015
In right sided peripheral lesion of the vestibular nerve the slow component of the nystagmus is directed
To the left To the right
To the direction of gaze
The direction is not characteristic
N21N0016
Which is not true of pseudobulbaris palsy
Dysarthria Dysphagia
Missing gag- and palatal reflexes
Brisk gag- and palatal reflexes
N21N0017
Where is the primary motor cortex?
In the frontal lobe In the precentral gyrus In area Br4
All of the above are true
N21N0018
What is characteristic of rigor
Cogwheel phenomenon
Frequently appears in Parkinson-syndrome Most prominent in the wrist and elbow All of the above are true
N21N0019
Which is not a pyramidal sign of the lower extremity?
Babinski-sign Brudzinski-sign Oppenheim-sign Chaddock-sign
N21N0020
Which is the pathway conveying pain and temperature sensation?
Fasciculus gracilis Fasciculus cuneatus
Spinothalamic tract (tractus spinothalamicus) All of the above
Tests
Single choice
N32N0001
These belong to the group of primary headaches:
migraine, tension type headache, headaches associated with cerebrovascular disease
migraine, tension type headache, cluster headache migraine, hypertensive headache, cluster headache
tension type headache, headache associated with low cerebrospinal fluid pressure
N32N0002
Primary headaches:
usually come in attacks
always present with continuous headache
present with attacks lasting for weeks and recur after a brief headache-free period would only stop after taking medications
N32N0003
One of the answers is true for primary headaches:
every attack of every patient is different from one another
the attacks of a given patient are usually similar to each other attacks recur once or twice a year
attacks recur several times a day
N32N0004
The diagnosis of primary headaches is based on:
the characteristic symptomatology of the attacks and a negative neurological examination
the results of neuroimaging studies
the results of neuroimaging and EEG studies
the results of neuroimaging, EEG and evoked potential studies
N32N0005
One of the answers is true for secondary headaches:
they always have an acute onset they never have an acute onset
beside the headache, the symptoms of the primary condition are discernible they are always bilateral
N32N0006
In headaches associated with space-occupying lesions:
pain is progressive
pain presents in short attacks
in most cases an epileptic seizure precedes the onset of the headache headache usually decreases or disappears with time
N32N0007
Headaches associated with subarachnoidal bleeding are characterized by:
a severe headache with a sudden onset
slowly progressing headache with the pain getting gradually more severe a headache with fluctuating pain severity (in the absence of painkillers) a mild but continuous pain
N32N0008
Headaches associated with physical activity, straining or coughing can be caused by:
giant cell arteritis cluster headache
Arnold-Chiari malformation medication overuse
N32N0009
Medication overuse headache can be caused by:
paracetamol taken on more than one day a week sumatriptan taken on more than 3 days a week sumatriptan taken on more than 4 days a month
a combined analgesic taken on more than one day a week
N32N0010
The treatment of medication overuse headache is:
patient education, analgesic withdrawal, prophylactic treatment analgesic withdrawal
prophylactic treatment without changing the dose of analgesics acupuncture
N32N0011
These fibers have a decisive role in the pathomechanism of primary headaches:
sensory fibers of the glossopharyngeal nerve sensory fibers originating from roots C3 to C5 sensory fibers of the vagal nerve
sensory fibers of the first branch of the trigeminal nerve
N32N0012
Primary headaches are caused by:
activation of the trigeminovascular system cerebrovascular diseases
pathological alterations of the cervical spine
is a consequence of nasal septal deviation
N32N0013
Activation of the trigeminovascular system:
causes vasoconstriction because of neurotransmitter-release causes nausea and vomiting by a direct effect on the vagal nerve causes a sterile inflammation and pain
can be terminated by vasodilatatory substances
N32N0014
The migraine aura:
is the name of the symptoms we can find in migraineurs between attacks is a transient CNS dysfunction at the beginning of a migraine attack is a characteristic alteration found with EEG in migraineurs between attacks is a characteristic alteration of the field of force found with EEG and evoked potentials in migraineurs between attacks
N32N0015
The most common migraine aura symptom is:
paresis
visual disturbance language disorder paresthesia
N32N0016
In order to diagnose migraine, the following are always necessary:
a detailed history, general medical and neurological examination, EEG, MRI a detailed history, general medical and neurological examination, MRI a detailed history, general medical and neurological examination general medical and neurological examination, EEG, MRI
N32N0017
To our current knowledge, migraine is caused by:
cerebrovascular disease (narrowing or dilatation of the vessels) primary dysfunction of the pain-sensitive system of the head repetitive pain stimuli caused by a lesion of the cervical spine psychosomatic disease
N32N0018
It is effective for the acute treatment of the migraine attack:
alprazolam (Xanax) tolperison (Mydeton) sumatriptan (Imigran) piracetam (Nootropil)
N32N0019
It is effective for the acute treatment of the migraine attack if given orally:
acetylsalicylate 1000 mg (Aspirin) ibuprofen 100 mg (Advil)
tolperison 150 mg (Mydeton)
N32N0019
The following are true for sumatriptan, except:
it can be used for the acute treatment of a migraine attack it can be used for the acute treatment of cluster headache
it can be administered during the pregnancy (for headache treatment)
due to its vasoconstrictive side effects, it is contraindicated in ischemic heart disease
N32N0020
The following are effective for the treatment of cluster headache, except:
subcutaneous sumatriptan 6 mg oral zolmitriptan 10 mg
100% oxygen through a non-rebreather mask
50% oxygen and 50% carbon dioxide through a non-rebreather mask
Questions
AN33N0001
What is impaired in movement disorders?
the primary motor cortex the motor circuit
the corticospinal tract the pulvinar thalami
AN33N0002
Which statement is true?
dyskinesias/hyperkinesias are always abnormal movements dyskinesias/hyperkinesias may be induced only by drugs
dyskinesias/hyperkinesias are always genetically determined
dyskinesias/hyperkinesias belong to the main motor symptoms of Parkinson’s disease
AN33N0003
Which of the following diseases does not belong to the group of movement disorders characterized by hyperkinesias?
Huntington’s disease Wilson’s disease Focal dystonias
Progressive supranuclear palsy (PSP)
AN33N0004
In the pathogenesis of Parkinson’s disease:
Only genetic factors are important
Only environmental factors are important The “dual” hypothesis is accepted Only aging is important
AN33N0005
What is not characteristic for Parkinson’s disease?
Dopamine deficiency
Compensating norepinephrine and serotonin overactivity Increased glutamate activity
Cholinergic overactivity
AN33N0006
Which staging explains the development of motor and non-motor symptoms of Parkinson’s disease over time?
Hoehn–Yahr staging
Pathological staging by Braak
UPDRS (Unifying Parkinson’s Disease Rating Scale) Epworth’s Sleep Scale (ESS)
AN33N0007
One of the following diseases belongs to the group of alpha-synucleinopathies:
Alzheimer’s disease
Multiple system atrophy (MSA) Progressive supranuclear palsy (PSP) Corticobasal degeneration (CBD)
AN33N0008
In which disease are Papp–Lantos bodies pathognostic?
Parkinson’s disease
Multiple system atrophy (MSA) Diffuse Lewy body dementia (DLBD) Alzheimer’s disease
AN33N0009
Where are the Papp–Lantos bodies found?
In the anterior horn motoneurons of the spinal cord In the cytoplasm of oligodendroglial cells
In the neurons of the pars compacta of substantia nigra In the wall of blood vessels
AN33N0010
Which symptom is not a motor symptom of Parkinson’s disease?
bradykinesia resting tremor rigidity
inspiratory stridor
AN33N0011
Which is not a prospective diagnostic criterion of Parkinson’s disease?
Lack of response of levodopa Unilateral onset
Resting tremor at the beginning
Motor fluctuation after 6-7 years of levodopa treatment
AN33N0012
What percent of parkinsonian patients develop depression?
20%
90%
40%
No depression occurs in Parkinson’s disease
AN33N0013
What percent of parkinsonian patients develop dementia?
Parkinsonian patients do not develop dementia, because it is not Alzheimer’s disease Dementia occurs only if the parkinsonian syndrome is the part of diffuse Lewy body dementia
In 40% of parkinsonian patients
In all parkinsonian patients, depending on disease duration
AN33N0014
In what order do the non-motor symptoms develop in Parkinson’s disease?
Loss of smell, sleep disturbances, depression Sleep disturbances, loss of smell, depression Depression, sleep disturbances, constipation Constipation, depression, sleep disturbances
AN33N0015
How much dopamine deficiency can be compensated by the striatum?
20%
40%
60%
80%
AN33N0016
What is the advantage of dopamine agonists?
They are free of dopaminergic adverse effects They do not influence daytime sleepiness They delay the development of dyskinesias
Patients do not need levodopa if they are on dopamine agonist therapy
AN33N0017
Which medication has proof of having a “disease modifying effect”?
pramipexole selegiline razagiline ropinirole
AN33N0018
What benefit is expected from the surgery (deep brain stimulation) in Parkinson’s disease?
To stop the progression of the disease Complete recovery
The best presurgical motor performance without drugs
The best presurgical motor performance with lower drug doses
AN33N0019
The disadvantages of levodopa therapy:
Loss of efficacy after several years of treatment Toxicity after several years of treatment
Development of dyskinesias after several years of treatment
Dopamine dysregulation syndrome develops in every case after several years of treatment
AN33N0020
The accepted treatment of focal dystonias is:
surgery tiapride
psychotherapy botulinum toxin
AN35N0001
Which of the following is true for viral meningitis?
It is most often due to herpes infection
Leukocytes count is increased in the cerebrospinal fluid The glucose level of the cerebrospinal fluid is unchanged Photophobia is characteristic
AN35N0002
The most common pathogens of meningitis in adulthood are:
Staphylococci
Neisseria meningitidis, Pneumococcus pneumoniae Corynebacterium diphteriae, Haemophilus influenzae Pneumococcus pneumoniae, Staphylococcus aureus
AN35N0003
Which of the following is true for both the viral and the bacterial meningitis?
Often asymptomatic
Fever, altered consciousness, meningeal signs and nuchal rigidity are seen Protein content and cell count is reduced in the cerebrospinal fluid Disease outbreaks are seasonal
AN35N0004
In meningitis caused by Listeria monocytogenes:
Many of lymphocytes are seen in the cerebrospinal fluid
Mixed cell types – lymphocytes and leukocytes are seen in the cerebrospinal fluid Many leukocytes are seen in the cerebrospinal fluid
Mixed cell types – lymphocytes and monocytes are seen in the cerebrospinal fluid
AN35N0005
The central nervous system is protected from the infection mainly by:
The blood-brain and the blood-CSF barrier Cellular immune response
Humoral immune response
Phagocytes present in the cerebrospinal fluid
AN35N0006
Encephalitis in Hungary is mainly due to:
Herpes simplex infection
Neisseria meningitidis infection Arbovirus infection
West-Nile virus infection
AN35N0007
The following are typical for encephalitis, except:
Starts with fever and altered consciousness
Pleiocytosis and elevated cell count are seen in the CSF It always has an infectious origin
Slow waves are typical on EEG
AN35N0008
Which of the following is not typical in herpes encephalitis?
Temporal lobe necrosis on MRI
Presence of Negri bodies in the Purkinje cells Altered consciousness
Presence of HSV-1 virus in the Gasser ganglia
AN35N0009
The following are symptoms of anti-NMDA receptor antibody encephalitis, except:
Aphasia
Psychotic state Perioral dyskinesia
Seizure
AN35N0010
Paraneoplastic encephalitis is most often due to:
Malignant melanoma Ovarian teratoma Colon cancer
Small cell lung cancer
AN35N0011
The prevalence of MS in Hungary is:
0-5/100,000 10-25/100,000 60-80/100,000 200/100,000
AN35N0012
The diagnosis of MS is definitive according to the McDonald criteria if
Relapses are disseminated in time and in space Relapses are disseminated in time
MRI lesions are disseminated in space Presence of one demyelinated lesion on MRI
AN35N0013
Axon lesions in MS are seen on MRI as:
Black holes on T1-weighted images
Hyperintense lesions on T2-weighted images Contrast enhanced lesions on T1-weighted images Spinal lesions
AN35N0014
The most common side effect of interferon-beta treatment is:
Flu-like symptoms Dizziness
Generalized skin rash Hair loss
AN35N0015
Visual evoked potential (VEP) is suitable to confirm:
Brainstem lesions Optic nerve lesions Spinal lesions
Eye movement disturbance
AN35N0016
The relapses in MS are treated with:
Steroids
Cyclophosphamide Interferon
Mannitol
AN35N0017
Which of the following is typical for Devic’s disease?
Cerebellar signs
Optic nerve and spinal symptoms Cognitive deficit
Seizures
AN35N0018
The following are typical symptoms for neuroborreliosis, except:
Meningitis with lymphocytes in the CSF Neuritis
Polyneuropathy
Increased intracranial pressure
AN36N0001
Which of the followings are not true?
Upper motoneuron signs are characteristic for ALS Lower motoneuron signs are characteristic for ALS Sensory disturbance is characteristic for ALS Sensory disturbance is not characteristic for ALS
AN36N0002
The criteria of definitive diagnosis of ALS are met in which of the following?
Amyotrophy on one limb and sensory signs on any other limb
Amyotrophy and hyperreflexia on two limbs and hypesthesia on the trunk
Progressive upper and lower motoneuron syndrome on the trunk, on an upper and a lower limb
Progressive upper and lower motoneuron syndrome on the trunk and all limbs, and anesthesia with an upper level at the clavicular line
AN36N0003
Specific signs of ALS are obtained by the following tests:
Spinal MRI
Electroneurography Examination of the CSF
All of the above statements are false
AN36N0004
Electromyographic findings in ALS:
Fibrillation potentials are frequently detected Decrement occurs after repetitive stimulation
Continuous, spontaneous muscle activity is characteristic Only one muscle is affected
AN36N0005
FTD is suspected if:
Early memory impairment is the main symptom
SSRI is ineffective in a 50-year-old woman with depression Parkinson’s syndrome is diagnosed in a 60-year-old man
Behavioral changes are the leading symptoms of the dementia, whereas memory and orientation decline usually later
AN36N0006
Differentiating FTD may be difficult from:
Acute stroke
Parkinson’s disease Alzheimer’s disease Hebephrenic schizophrenia
AN36N0007
When FTD is suspected, MRI is useful because:
Alzheimer’s disease can be excluded Unequivocal signs of FTD are detected Excludes focal intracranial lesions
All the above statements are false, because MRI examination is uninformative in FTD
AN36N0008 FTD:
is treated with donepezil is treated with dopamine is treated with memantine is presently untreatable
AN36N0009
The cognitive symptoms listed in the DSM-IV criteria of dementia are the following:
Aphasia, agnosia, apraxia, alexia
Aphasia, agnosia, apraxia, executive dysfunction Aphasia, alexia, apraxia, executive dysfunction Agraphia, agnosia, apraxia, alexia
AN36N0010
The following are characteristic for subcortical dementia, EXCEPT:
rigidity myoclonus tremor chorea
AN36N0011
In conformational diseases:
the primary structure of the proteins is changed
the secondary structure of the proteins is changed the structure of the DNA is changed
none of the above
AN36N0012
The following are typical for Alzheimer's disease, EXCEPT:
early memory problems BPSD symptoms
pathological EEG
temporal hypometabolism on PET examination
AN36N0013
The following are parts of the Mini Mental State Examination (MMSE), EXCEPT:
orientation
copying intersecting hexagons naming
examination of short-term memory
AN36N0014
The following are used to treat the cognitive symptoms of Alzheimer's disease, EXCEPT:
donepezil riluzole rivastigmine memantine
AN36N0015
The following is characteristic for diffuse Lewy body dementia:
parkinsonism, visual hallucinations, delirium
parkinsonism, visual hallucinations, fluctuation parkinsonism, acoustic hallucinations, delirium parkinsonism, acoustic hallucinations, fluctuation
AN36N0016
The following is characteristic for Creutzfeldt-Jakob's disease:
dementia, myoclonus, cerebellar signs dementia, myoclonus, corticospinal signs dementia, myoclonus, brainstem signs dementia, myoclonus, sensory signs
AN36N0017
Characteristic inclusions in Alzheimer's disease:
neurofibrillary tangles, Lewy bodies neurofibrillary tangles, senile plaques neurofibrillary tangles, kuru plaques
neurofibrillary tangles, intranuclear inclusions
AN36N0018
The following is/are used in the diagnosis of Alzheimer's disease:
MRI PET CSF
all of the above
AN36N0019
Atrophy is most prominent in the following brain areas in Alzheimer's disease:
frontal lobe temporal lobe parietal lobe occipital lobe
AN36N0020
The following are risk factors for Alzheimer's disease, EXCEPT:
female gender low education
apolipoprotein epsilon2 allele hypertension
Simple choices
AN37N0001
Which of the following is a direct life-threatening herniation?
Lateral Uncal Tonsillar Extracranial
AN37N0002
Which of the following causes cytotoxic (intracellular) brain edema?
Brain tumors Hydrocephalus Encephalitis
Metabolic disorders
AN37N0003
What is the method of choice for the treatment of a 10 mm vestibular schwannoma?
Surgical removal Chemotherapy WBRT
Radiosurgery
AN37N0004
Which of the following is not true for primary CNS lymphomas?
Steroid treatment decreases their size Originates from B-lymphocytes
Extraneural organs are not affected Surgical removal is indicated
AN37N0005
Typical for meningiomas:
Do not cause epilepsy
Each may be surgically removed
After surgery, radiation therapy is needed
In small and asymptomatic tumors, regular CT or MRI follow-up is sufficient
AN37N0006
Pituitary tumors produce which of the following hormones most commonly?
GH TSH ACTH Prolactin
AN37N0007
Which tumor’s typical appearance is the butterfly-tumor?
Plexus papilloma Ependymoma Oligodendroglioma Glioblastoma
AN37N0008
The typical location of a spinal meningioma is:
Intramedullary
Intradural, extramedullary Extradural
AN37N0009
Which tumor may cause dissociated sensory loss?
Extramedullary spinal tumor in the cervical region Intradural tumor in level L3
Intramedullary tumor in level C5-7
Meningioma overlying the post-central gyrus
AN37N0010
Tumors in the pineal region often cause:
Epilepsy
Bitemporal hemianopia Occlusive hydrocephalus Non-resorptive hydrocephalus
AN37N0011
What is the typical age of medulloblastoma?
0.5 to 2 years 3-10 years 15-20 years 40-60 years
AN37N0012
Typical for oligodendrogliomas:
Never become malignant Cause epilepsy very often Calcification is not common Originate from the cerebellum
AN37N0013
Which neurologic symptom is caused most commonly by a pituitary macroadenoma?
Homonymous hemianopia
Binasal heteronymous hemianopia
Bitemporal heteronymous hemianopia Bitemporal homonymous hemianopia
AN37N0014
Symptoms of a vestibular schwannoma:
Ipsilateral central facial palsy, hearing loss, vertigo Unilateral blurred vision, tinnitus, epilepsy
Bilateral abducens nerve palsy, dementia, dizziness
Ipsilateral peripheral facial nerve palsy, tinnitus, hearing loss
AN37N0015
Which cancer is common in patients with AIDS?
Glioblastoma Medulloblastoma Ependymoma
Primary central nervous system lymphoma
AN37N0016
What is the treatment of choice for a patient with advanced small-cell lung cancer with 6 small brain metastases?
Surgical removal of brain metastases, chemotherapy WBRT, chemotherapy, or radiation surgery
Chemotherapy Radiosurgery
AN37N0017
Which method is suitable for identifying the eloquent areas?
Functional MRI
Diffusion-weighted MRI SPECT
MRI-spectroscopy
AN37N0018
The 3 most common sources of brain metastases:
Lung, breast, unknown
Lung, melanoma, gastrointestinal Breast, colon, kidney
Lung, prostate, uterus
AN37N0019
Which drug is used in case of a hormone-producing pituitary adenoma?
Madopar Selegiline Haloperidol Bromocriptine
AN37N0020
What is the best treatment for meningeal carcinomatosis?
Intrathecally administered cytostatic drug Irradiation
Radiosurgery Brachytherapy
AN37N0021
Which antiepileptic drug would you choose first in focal epilepsy caused by brain metastasis?
Phenytoin
Carbamazepine Ethosuximide Diazepam
AN37N0022
In what form is temozolamide used?
Intravenous infusion Intra-arterial catheter Oral
Intramuscular depot injection
AN37N0023
Which cancer is more common in women?
Medulloblastoma Ependymoma Glioblastoma Meningioma
AN37N0024
Which value represents normal intracranial pressure?
150 mm of water 150 cm of water 150 mm of Hg 300 mm of water
AN37N0025
Which of the following tumor type is likely to give CSF metastases?
Medulloblastoma Vestibular schwannoma Ganglioglioma
Astrocytoma A2
AN38N0001
True for the dissociated sensory loss:
It is due to an isolated spinothalamic deficit Spinothalamic function is normal
It is caused by extramedullary tumors
It is seen in posterior spinal artery syndrome
AN38N0002
Not true for acute transverse lesion:
Flaccid paraparesis Overflow incontinence Paralytic ileus
Spinal automatisms
AN38N0003
Not true for cauda syndrome:
Babinski sign
Bilateral lumbosacral signs Autonomic dysfunction Areflexia in the lower limbs
AN38N0004
True for spinal ataxia:
Worsens when eyes are closed Pain sensation is diminished Proprioception is normal
Not seen in subacute combined degeneration
AN38N0005
Not true of sciatic pain:
Sudden onset Severe lumbar pain Often unilateral
Presence of Lhermitte’s sign
AN38N0006
What distinguishes Devic’s disease from MS?
The age of onset
The extent of the spinal lesions The lack of intracranial lesions All of the above
AN38N0007
Which signs are not typical for the anterior spinal artery syndrome?
Spinal ataxia
Corticospinal tract lesion Segmental motor deficit
Loss of pain and temperature sensation
AN38N0008
The diagnosis of subacute combined degeneration involves:
Spinal MRI, lab tests Cerebrospinal fluid tests Spinal biopsy
Spinal CT, lab test
AN38N0009
Transverse myelitis is often seen in:
Herpes zoster
Systemic lupus erythematosus Poliomyelitis acuta anterior Spondylodiscitis
AN38N0010
The recommended treatment for spinal arteriovenous malformations is:
Stereotaxic radiosurgery (gamma-knife) Endovascular catheterisation
Endoscopic surgery
Whole spine X-ray irradiation
AN38N0011
What is the most common location of spinal tumors?
Intramedullary
Intradural-extramedullary Extradural
AN38N0012
What is the most common type of spinal extradural tumor?
Metastasis
Osteoma Chordoma Osteoblastoma
AN38N0013
What is the least common site of spinal tumors?
Intramedullary
Intradural-extramedullary Extradural
AN38N0014
Not true for syringomyelia:
Dissociated sensory loss
Central cavity in the spinal cord
Association with Arnold-Chiari malformation Association with tethered cord syndrome
AN38N0015
The typical location of thoraco-lumbar spinal cord injury is:
Upper thoracic region Thoraco-lumbar junction Lower lumbar region
Equally frequent in all of the above locations
AN38N0016
The following is not recommended in the prehospital care of spinal cord trauma:
Stabilization of vital signs to maintain spinal perfusion Temporary stabilization of the injured vertebral column
Transport of the comatose patient without intratracheal intubation
AN38N0017
Not true for the degenerative spinal diseases:
They are common disorders Their frequency is rising with age
They are most common in the thoracic segment They lead to decreased ability to work
AN38N0018
The following is not characteristic of cervical discal herniation:
Central spinal cord syndrome Brachialgia
Nerve root compression
Typically located at C5-6, 6-7 segments
AN38N0019
Characteristic for lumbar discal herniation:
It may cause cauda syndrome Not associated with pain
It’s most common location is L4-5 and L5-S1 segments It causes low back pain and sciatica
AN38N0020
What is the optimal method to confirm cervical discal herniation?
CT X-ray MRI EMG
Neurology III./9.8. Questions AN_III_9_fejezet
AN39N0001
What is the consequence of nerve damage with focal demyelination?
muscle atrophy conduction block no symptom only fasciculation
AN39N0002
How much time is needed for a nerve lesion with focal demyelination to resolve?
at least one year few days 1-2 months 6 months
AN39N0003
If there is a loss of axonal continuity, what is the rate of growth of the regenerating axon?
1 mm/day
1 mm/week 1 mm/month 1 cm/month
AN39N0004
When is nerve regeneration possible in case of neurotmesis?
always
if the limb is immobilized if nerve suture is done never
AN39N0005
What is typically the first symptom of a nerve compression?
numbness muscle atrophy paralysis muscle cramp
AN39N0006
Which of the following drugs/class of drugs are effective in neuropathic pain?
non-steroid anti-inflammatory drugs steroids
gabapentin paracetamol
AN39N0007
What is the typical initial symptom of carpal tunnel syndrome?
thenar atrophy
painful paresthesia of the hand during the night trophic ulcers on the fingers
sweating of the hand
AN39N0008
Which of the following is the typical hand posture in ulnar nerve lesion?
oath hand wrist drop claw hand finger drop
AN39N0009
Which of the following is the most common site of ulnar nerve lesion?
cubital tunnel
wrist forearm
behind the medial epicondyle in the ulnar groove
AN39N0010
Which of the following is the most common site of radial nerve lesion?
wrist
middle part of the upper arm axilla
elbow
AN39N0011
What is meralgia paresthetica?
compression of the common peroneal nerve at the fibular head lumbosacral plexopathy
lesion of the lateral femoral cutaneous nerve the Latin term for numbness in general
AN39N0012
What can cause a foot drop?
common peroneal nerve lesion sciatic nerve lesion
L5 radiculopathy all of the above
AN39N0013
Which of the following is affected in an upper brachial plexopathy?
abduction of the arm dorsiflexion of the wrist abduction (spreading) of fingers elevation of the shoulder
AN39N0014
In thoracic outlet syndrome, what is the distribution of sensory loss and weakness?
C7 Th1 Th2 C6
AN39N0015
Which nerve is damaged in a retroperitoneal hemorrhage?
lumbar plexus
sciatic nerve
lateral femoral cutaneous nerve tibial nerve
AN39N0016
Which of the following may be caused by polyneuropathy?
burning pain of the feet cold feeling of the feet non-healing ulcer on the sole all of the above
AN39N0017
What is the most common cause of polyneuropathy in Hungary?
Guillain-Barré syndrome systemic vasculitis diabetes mellitus HIV
AN39N0018
Which of the following is not a typical symptom of Guillain-Barré syndrome?
areflexia flaccid paresis
respiratory insufficiency muscle atrophy
AN39N0019
What test should be done in small-fiber neuropathy of unknown origin?
oral glucose tolerance test cerebrospinal fluid
erythrocyte sedimentation rate genetic test
AN39N0020
Which type of polyneuropathy should be treated with vitamin B1?
critical illness polyneuropathy cisplatin induced polyneuropathy
polyneuropathy associated with alcoholism leprosy
AN310N0051
One of the following disorders does not belong to the group of muscular dystrophies:
Becker muscular dystrophy
Dysferlinopathy
Curschmann-Steinert disease Eaton Lambert syndrome Sarcoglycanopathy
AN310N0052
For one of the following metabolic myopathies, an enzyme replacement treatment is available:
Carnitine deficiency McArdle’s disease Mitochondrial disorders Pompe disease
Carnitine-epalmytine-transferase deficiency (CPTII)
AN310N0053
Which statement is incorrect?
Dystrophin is the largest component of the binding complex between cytoskeletal actin and the extracellular matrix.
The out of frame deletion leads to the less severe Duchenne muscular dystrophy with a better prognosis.
The AD inherited facioscapulohumeral muscular dystrophy (FSHD) can be diagnosed by genetic testing showing the reduction of D4Z4 repeat.
Myotonic dystrophy type I is an autosomal dominant trinucleotide repeat disease caused by the pathological CTG expansion of the myotonin protein kinase gene.
Among the channel disorders, alteration of the function of the chloride channel leads to a dysfunction of contraction and relaxation in muscles.
AN310N0054
One of the following diseases does not belong to the group of hereditary metabolic myopathies:
Mitochondrial myopathy due to the dysfunction of oxydative phosphorylation.
In McArdle’s disease, glycogenolysis is altered due to the deficiency of myophosphorylase.
Deficiency of alpha-glucosidase is a lysosomal glycogen storage disease.
Disorders due to the dysfunction of cytosolic molecules, such as calpain, telethonin, and titin.
Deficiency of carnitine with disturbance of lipid storage.
AN310N0055
Which statement is incorrect?
In dermatomyositis caused by a humoral immune reaction, membrane attack complexes are deposited in vessel walls and the endothelium.
In polymyositis, CD8+ T lymphocytes and macrophages form endomysial infiltrations.
Clinical symptoms of myasthenia gravis may appear as part of a paraneoplastic syndrome.
Antibodies against thymic myoid cells are responsible for the dysfunction of neuromuscular transmission.
In inclusion body myositis, damage of the nuclei of muscle cells is present with intranuclear filamental structures.
AN310N0056
Which statement is incorrect?
Corticosteroid treatment can cause acute tetraplegic myopathy.
Due to corticosteroid treatment, Ca intake in the sarcoplasmatic reticulum may decrease and glycogen synthesis may increase.
Due to corticosteroid treatment protein degradation in the muscle cell can increase.
Due to corticosteroid treatment, endomysial infiltration of CD8 positive T-lymphocytes and macrophages is present.
AN310N0057
One of the following agents can cause toxic myopathy:
Paracetamol Penicillin Insulin Statins
ACE inhibitors
AN310N0058
Clinical symptoms of muscle disorders: which is incorrect?
Proximal muscle weakness Peroneal muscle weakness Increased muscle tone Muscle atrophy
Muscle pain
AN310N0059
In one of the diseases below, the following symptoms are characteristic: muscle involvement, cataract, gynecomastia, endocrine dysfunction, and cardiomyopathy.
Facioscapulohumeral muscular dystrophy Kearn-Sayres syndrome
Inclusion body myositis (IBM) McArdle’s disease
Myotonic dystrophy
AN310N0060
One of the following symptoms is typical for dermatomyositis: (only one answer is correct)
Symmetric ptosis Gottron papules Erythema migrans Raynaud symptoms Distal muscle weakness
AN310N0061
One of the following laboratory parameters is not increased in inflammatory myopathy.
GOT CK LDH GPT ALP
AN310N0062
One of the statements is incorrect:
As a result of physical exercise, serum lactate level may increase three-fold compared to baseline.
When anaerobic metabolism is impaired, serum lactate levels increase.
Disturbance of the electron transport chain and increased anaerobic metabolism are responsible for elevated lactate levels.
Activation of glycolytic processes may lead to the elevation of lactate levels and cause lactate acidosis.
The diagnostic value of serum lactate and pyruvate is important in metabolic muscle disorders.
AN310N0063
In electromyography, three of the following features are present in myopathy.
Spontaneous activity, such as positive sharp waves Large motor units
Small and short motor units Polyphasic motor units Reduced interference pattern
AN310N0064
In two of the following diseases, pathological decrement is obtained with repetitive 3 Hz stimulation:
Myasthenia gravis
Eaton-Lambert syndrome Dermatomyositis
Mytonic dystrophy Inclusion body myositis
AN310N0065
In one of the following diseases, muscle biopsy is not informative:
Mitochondrial myopathy Polymyositis
Myasthenia gravis FSHD
Inclusion body myositis
AN310N0066
Which medication is the treatment of first choice in polymyositis?
Diclofenac
Methylprednisolone Azathioprine
Cyclophosphamide Pyridostigmine
AN310N0067
In myasthenia gravis, 3 of the following medications are commonly used:
Cyclophosphamide Methylprednisolone Azathioprine
Mexiletine Pyridostigmine
AN310N0068
Two of the following statements about physiotherapy recommended for patients with muscle disorders are correct.
An improvement of aerobic capacity may be achieved by a low to moderate level aerobic exercise program.
Excentric exercise (contraction during muscle extension) is beneficial for muscle function.
For patients with muscular disorders, exercise with a low repetition number but great force is recommended.
Concentric muscle exercise and passive physiotherapy are recommended.
Muscle soreness is a positive predictive marker for the efficacy of exercise.
AN310N0069
What type of diagnostic tests are recommended if the patient complains of shortness of breath during exercise or even rest, morning headache, and lightheadedness. Three answers are correct.
Pulmonary function test Multiple sleep latency test Sleep test
MRI of the head Blood gas analysis
AN310N0070
Symptoms of MELAS disease are : (1 answer is not correct)
Epilepsy
Diabetes mellitus Juvenile stroke Myoglobinuria Migraine
AN3111N001
The normal values of blood pressure are:
<125 / <80 mmHg
<130 / <90 mmHg
<120 / <80 mmHg
<135/ <85 mmHg
AN311N002
What percent of hypertensive patients have essential hypertension?
50%
70%
80%
95%
AN311N003
The range of autoregulation of cerebral circulation in healthy subjects is:
100-200 mmHg 60-160 mmHg 80-180 mmHg 50-150 mmHg
AN311N004
Typical CT scan findings in hypertensive encephalopathy are:
Hyperdensity in territory of basal ganglia Hypodensity in borderzones
Massive contrast enhancement in frontal lobes
Patchy hypodensity around the occipital and frontal horns of the lateral ventricles
AN311N005
Which of the following is true for lacunar encephalopathy?
Ischemic lesions with diameter below 25 mm on CT scan.
Lacunar infarcts most often appear in the cerebellum.
It occurs in patients with poorly controlled diabetes or hypertension.
Lacunar lesions often cause sensory or motor aphasia.
AN311N0006
Which of the following is true for intracerebral hemorrhage?
Symptoms develop gradually over the course of days.
Urgent CT scan shows hyperdensity.
MRI is unsuitable for the diagnosis.
The treatment of choice is surgery, or conservative treatment if not possible.
AN311N0007
The cardiac sources of emboli in decreasing order of frequency are:
atrial fibrillation - post myocardial infarct – other heart diseases - artificial heart valves post myocardial infarct – atrial fibrillation - other heart diseases
artificial heart valves – atrial fibrillation – post myocardial infarct artificial heart valves – post myocardial infarct - atrial fibrillation
AN311N0008
Which of the following is true for cerebral embolism?
It often occurs in the evening, before going to bed.
Neurological symptoms develop suddenly, and they are most severe at the onset.
Cardiac emboli most often cause lacunar infarcts.
Transthoracal echocardiography shows an intracardiac source of emboli in 70% of cases.
AN311N0009
Which of the following is true for atrial fibrillation?
The most common supraventricular tachyarrhythmia.
Its most common clinical symptom is chest pain.
The risk of stroke is the highest in the paroxysmal form of atrial fibrillation.
Oral anticoagulant therapy is always indicated in the chronic form, INR should be 2.5-3.5.
AN311N0010
Which of the following is true for myocardial infarction?
The most common cause is spontaneous spasm of coronary arteries; the stenosis of coronary arteries is rare.
Lancinating chest pain is typical, which increases with inspiration.
The sudden decrease of cardiac output may lead to syncope or borderzone infarct.
Anticoagulant therapy is indicated in all cases.
AN311N0011
What type encephalopathy is uremic encephalopathy?
Metabolic encephalopathy Alcoholic encephalopathy Paraneoplastic encephalopathy Hypoxic encephalopathy
AN311N0012
Uremic encephalopathy develops if serum creatinine is above:
300 µM/L 700 µM/L 1000 µM/L 1200 µM/L
AN311N0013
The most characteristic symptom of uremic encephalopathy is:
Hemihypesthesia Epileptic seizures
Involuntary movements Pyramidal signs
AN3110014
The most typical neurological symptom of disequilibrium syndrome is:
Nausea
Muscle cramps Agitation Headache
AN311N0015
The most frequent peripheral nervous system complication of chronic uremia is:
Uremic polyneuropathy
Uremic myopathy ALS
Myositis
AN311N0016
The following are true for paraneoplastic neurological syndromes, except:
Caused by a hormone produced by the tumor Molecular mimicry
Incidence is 0.1-1% in patients with malignancy
In 60-80% of cases, the paraneoplastic neurological syndrome precedes the diagnosis of the malignancy.
AN311N0017
The following are true for nervous system metastases, except:
In adults, CNS metastases are more common than primary brain tumors.
Metastases are equally common in the spinal cord and the brain.
The appearance of CNS metastases increases mortality.
Acute “stroke like” onset is caused by a sudden intratumoral hemorrhage.
AN311N0018
If meningeal carcinomatosis is suspected, the most important diagnostic test is:
MRI CT
CSF examination Biopsy
AN311N0019
The following are false, except:
The primary tumor is unknown in up to 15% of patients at the diagnosis of the metastasis.
CSF is always pathological in paraneoplastic syndromes affecting the central nervous system.
Surgical treatment is never indicated in multiple cerebral metastases.
In meningeal carcinomatosis, CSF cell count is usually several thousand.
AN311N0020
Which complication is typical for acute hyperglycemic ketoacidosis?
Focal neurological symptoms are not frequent 100% mortality
Distal neuropathy
AN311N0021
Which of the following is not typical for hypoglycemic encephalopathy?
Coma
Always reversible Sudden behavioral change Always irreversible
AN311N0022
Which of the following is true for diabetes mellitus as a stroke risk factor?
Increased stroke risk, but only in males Increased stroke risk, but only in females Six-fold increase of stroke risk in both genders 1.5-6-fold increase of cerebral atherothrombosis
